TY  - JOUR
T1  - Predicting psychosis: Meta-analysis of transition outcomes in individuals at high clinical risk
AU  - Fusar-Poli P, Bonoldi I, Yung AR, et al
Y1  - 2012/03/01
N1  - 10.1001/archgenpsychiatry.2011.1472
JO  - Archives of General Psychiatry
SP  - 220
EP  - 229
VL  - 69
IS  - 3
N2  - Context 
                  A substantial proportion of people at clinical high risk of psychosis will develop a psychotic disorder over time. However, the risk of transition to psychosis varies between centers, and some recent work suggests that the risk of transition may be declining.Objective 
                  To quantitatively examine the literature to date reporting the transition risk to psychosis in subjects at clinical high risk.Data Sources 
                  The electronic databases were searched until January 2011. All studies reporting transition risks in patients at clinical high risk were retrieved.Study Selection 
                  Twenty-seven studies met the inclusion criteria, comprising a total of 2502 patients.Data Extraction 
                  Transition risks, as well as demographic, clinical, and methodologic variables, were extracted from each publication or obtained directly from its authors.Data Synthesis 
                  There was a consistent transition risk, independent of the psychometric instruments used, of 18% after 6 months of follow-up, 22% after 1 year, 29% after 2 years, and 36% after 3 years. Significant moderators accounting for heterogeneity across studies and influencing the transition risks were the age of participants, publication year, treatments received, and diagnostic criteria used. There was no publication bias, and a sensitivity analysis confirmed the robustness of the core findings.Conclusions 
                  The state of clinical high risk is associated with a very high risk of developing psychosis within the first 3 years of clinical presentation, and the risk progressively increases across this period. The transition risk varies with the age of the patient, the nature of the treatment provided, and the way the syndrome and transition to psychosis are defined.
SN  - 0003-990X
M3  - doi: 10.1001/archgenpsychiatry.2011.1472
UR  - http://dx.doi.org/10.1001/archgenpsychiatry.2011.1472
ER  -